| NPI | 1467988980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000007797) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW76229) |
| 1041C0700X Social Worker, Clinical (Licence: CA LCSW100493) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2022-03-21 |