| NPI | 1487990537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW-21683) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-07715) |
| 104100000X Social Worker (Licence: IA 007900) | |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2023-07-11 |