| NPI | 1821597162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW19654) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 10282) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2024-05-14 |