| NPI | 1790283026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 12223-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2025-04-11 |