NPI | 1174912232 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101Y00000X Counselor |
104100000X Social Worker (Licence: CA 97119) | |
Enumeration Date | 2015-01-13 |
Last Update Date | 2023-08-10 |