NPI | 1134868649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: ID 42215) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 108183) |
1041C0700X Social Worker Clinical (Licence: CA 108183) | |
1041C0700X Social Worker Clinical (Licence: ID 42215) | |
Enumeration Date | 2022-06-02 |
Last Update Date | 2022-06-02 |