| NPI | 1700094950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 992445) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 00992445) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2024-02-03 |