| NPI | 1871178160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW22784) |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker | |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2024-03-15 |