NPI | 1114225653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 289637-3503) |
Enumeration Date | 2011-03-08 |
Last Update Date | 2021-01-08 |