| NPI | 1851993034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904012424) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06291100) |
| 1041C0700X Social Worker, Clinical (Licence: FL SW23022) | |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2025-09-24 |