| NPI | 1871089698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60799056) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA 60799056) |
| 104100000X Social Worker (Licence: WA LW60799056) | |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2022-11-01 |