| NPI | 1750698825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-10915) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-08317) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2019-10-20 |