| NPI | 1659422822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH I5458) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I-0005458) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-04-23 |