| NPI | 1497266209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.1800998) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH s.1201433) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2019-01-23 |