NPI | 1023533296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000882) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 14888) |
Enumeration Date | 2017-08-09 |
Last Update Date | 2017-08-09 |