| NPI | 1578709077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW017781) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0012807) |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2025-10-06 |