NPI | 1275025926 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 23796) |
Additional Taxonomies | 104100000X Social Worker (Licence: MD 23796) |
Enumeration Date | 2018-05-30 |
Last Update Date | 2022-05-06 |