NPI | 1194366294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 9677-C) |
Additional Taxonomies | 104100000X Social Worker (Licence: AR 9677-M) |
Enumeration Date | 2019-10-01 |
Last Update Date | 2024-06-18 |