NPI | 1023435807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC200001949) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2011009028) |
Enumeration Date | 2014-03-18 |
Last Update Date | 2025-08-13 |