| NPI | 1477401073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2608329) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.230942) |
| Enumeration Date | 2026-03-19 |
| Last Update Date | 2026-08-19 |