| NPI | 1548330939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW13890) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS14863) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2017-01-30 |