NPI | 1235618166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SC60735158) |
Additional Taxonomies | 104100000X Social Worker (Licence: WA SC60735158) |
Enumeration Date | 2018-08-10 |
Last Update Date | 2019-02-07 |