| NPI | 1457877391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 9759-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 7119-S) |
| 1041C0700X Social Worker, Clinical (Licence: NV IC-1243) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-04-18 |