NPI | 1083822720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904007232) |
Additional Taxonomies | 1041C0700X Social Worker Clinical |
Enumeration Date | 2007-05-18 |
Last Update Date | 2024-03-13 |