| NPI | 1740693274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 7220-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW21752) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2023-12-28 |