| NPI | 1821110834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.7380-S) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I 7380) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-10-08 |