NPI | 1144715756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 13124) |
Additional Taxonomies | 104100000X Social Worker (Licence: LA 13124) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2022-06-21 |