NPI | 1164443800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW8499) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34002831A) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2018-09-04 |