NPI | 1063988327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61508432) |
Additional Taxonomies | 104100000X Social Worker (Licence: FL PSW1398) |
Enumeration Date | 2018-10-15 |
Last Update Date | 2024-07-26 |