| NPI | 1447281290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0007429-SUPV) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: RI ISW01447) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2024-11-06 |