NPI | 1841414554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0009966-SUPV) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I 0009966) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2018-06-26 |