| NPI | 1891331344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2204014) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2004970) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2022-11-21 |