NPI | 1053810564 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60753397) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2018-02-09 |
Last Update Date | 2018-05-17 |