NPI | 1235378340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-30619) |
Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW-25238) |
Enumeration Date | 2009-02-12 |
Last Update Date | 2023-09-28 |