NPI | 1144732470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW114075) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 77369) |
Enumeration Date | 2017-10-26 |
Last Update Date | 2023-03-14 |