| NPI | 1497005250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW12431) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 4521) |
| 1041C0700X Social Worker, Clinical (Licence: FL ISW 6916) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2021-07-14 |