| NPI | 1801326020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2002422) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1700938) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2020-11-03 |