| NPI | 1518503580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2506288) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2207644) |
| 104100000X Social Worker (Licence: OH S.1901119-TRNE) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2025-10-15 |