| NPI | 1730213034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I0014717) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I1000254) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2022-09-01 |