NPI | 1053837443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 10341) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 08092017273360) |
Enumeration Date | 2017-08-17 |
Last Update Date | 2023-06-24 |