NPI | 1215685920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 122634) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 102954) |
Enumeration Date | 2022-03-11 |
Last Update Date | 2024-08-09 |