| NPI | 1609392539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 8594-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV IC-1130) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-07-21 |