| NPI | 1851583769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL ISW 2846) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2017-05-08 |