| NPI | 1801370531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09926936) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2020-10-19 |