| NPI | 1841419546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CW018114) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA sw124221) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2016-10-07 |