| NPI | 1659649556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I 1430098) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH 1430098) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2022-07-21 |