| NPI | 1447422217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C007682) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NC P004440) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2017-08-21 |