| NPI | 1881758704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I-04325) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I0004325) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-08-08 |