| NPI | 1891720694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NV M-9800) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LISW - 2925) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-03-23 |