| NPI | 1881940559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 11652-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW006928) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2024-11-21 |