| NPI | 1841844511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NV 5007-S) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NV 9470-C) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-08-02 |