| NPI | 1740307289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000934) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078329) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-09-27 |