| NPI | 1801581806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09926745) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 12456242-3501) |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-04-06 |