| NPI | 1518511807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2203992) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1904077) |
| 104100000X Social Worker (Licence: OH I.2203992) | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2024-05-07 |