| NPI | 1548735194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH S.1903316) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH s.1903316) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-10-29 |