| NPI | 1487421848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007902) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA 007902) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2024-08-23 |