| NPI | 1801245311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I1801307-S) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 1600303) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2022-08-29 |