| NPI | 1518046911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I000329) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I 000329) |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2008-07-30 |