NPI | 1972510568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH 0001123) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 0001123) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2024-07-03 |