| NPI | 1477784759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60282782) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA RC60085387) |
| 104100000X Social Worker (Licence: WA SC60125850) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2022-04-26 |