| NPI | 1932185097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 001851) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2013-11-14 |