| NPI | 1598069601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH S.0031362) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S0031362) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2021-06-06 |