| NPI | 1598957680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 7141-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 001164) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2018-12-27 |