| NPI | 1467027649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 10450-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV 9244-S) |
| 1041C0700X Social Worker, Clinical (Licence: MN 29066) | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2023-01-23 |