| NPI | 1477047561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P012728) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-09-11 |