NPI | 1235621434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW021303) |
Additional Taxonomies | 104100000X Social Worker (Licence: PA 134132) |
Enumeration Date | 2018-06-04 |
Last Update Date | 2023-03-28 |