| NPI | 1871814137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I1000032) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH I1000032) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2021-01-14 |