| NPI | 1447341953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 14632) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34006202A) |
| 104100000X Social Worker (Licence: OH I0007774SUPV) | |
| 1041C0700X Social Worker, Clinical (Licence: OH I0007774) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-03-15 |