| NPI | 1508378068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH 0007776-supv) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH I.0007776) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2020-07-03 |