NPI | 1073294005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW24498) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 7585) |
1041C0700X Social Worker, Clinical (Licence: FL 18628) | |
Enumeration Date | 2023-07-31 |
Last Update Date | 2025-04-01 |