| NPI | 1518281997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2010001325) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000989) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2010-03-15 |