| NPI | 1962544791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 7728-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 4081) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-09-26 |