| NPI | 1841625803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004903) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AK 1246) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2014-10-07 |