| NPI | 1659808897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH I.1700352) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH 1700352) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2021-12-30 |