| NPI | 1841261401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C004252) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C-004252) |
| 1041C0700X Social Worker, Clinical (Licence: NC C-004245) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2025-01-14 |