NPI | 1306507249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 106840) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 106840) |
Enumeration Date | 2022-01-03 |
Last Update Date | 2024-08-02 |