NPI | 1174578397 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60655972) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: HI 3219) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2024-10-10 |