| NPI | 1952618886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I 1100066) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S0800888) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2011-04-28 |