| NPI | 1730337346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI LCSW-4787) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L14122) |
| 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-23044) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 83746) | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2025-07-11 |