| NPI | 1487996740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-10855) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 8564) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2023-05-09 |