| NPI | 1609443498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2406161) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.028448) |
| 104100000X Social Worker (Licence: ID LMSW-44292) | |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-12-26 |