| NPI | 1932944576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09933520) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO SWC.0000002051) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2026-07-30 |