NPI | 1033948971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: VA 0903004220) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 116949) |
Enumeration Date | 2024-07-30 |
Last Update Date | 2025-08-25 |