| NPI | 1750032579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA SC61399664) |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2023-02-27 |