NPI | 1194153429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 6605) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW.00992346) |
Enumeration Date | 2013-10-23 |
Last Update Date | 2019-05-20 |