NPI | 1023221967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2020023042) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW9297) |
1041C0700X Social Worker, Clinical (Licence: DC LC50081569) | |
Enumeration Date | 2007-05-07 |
Last Update Date | 2022-02-24 |