NPI | 1245677483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005335) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C008289) |
Enumeration Date | 2013-05-29 |
Last Update Date | 2022-04-22 |