| NPI | 1598913139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-11531) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: TX 53949) | |
| 1041C0700X Social Worker, Clinical (Licence: NM X-06368) | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2024-05-15 |