| NPI | 1497279202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI 4260) |
| Additional Taxonomies | 104100000X Social Worker (Licence: HI 2147) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-09-21 |