NPI | 1275853103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C004437) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 7329) |
Enumeration Date | 2010-06-02 |
Last Update Date | 2024-10-18 |