NPI | 1144792318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC60266004) |
Additional Taxonomies | 104100000X Social Worker (Licence: WA SC60266004) |
Enumeration Date | 2018-12-27 |
Last Update Date | 2018-12-27 |