| NPI | 1447492111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 4698) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AR 22478-C) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2024-04-19 |