NPI | 1255881975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C012860) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM C-10616) |
Enumeration Date | 2016-10-05 |
Last Update Date | 2023-06-05 |