NPI | 1194193623 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 6226) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34006131A) |
Enumeration Date | 2015-09-15 |
Last Update Date | 2022-03-13 |