NPI | 1316362221 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL 16031) |
Additional Taxonomies | 104100000X Social Worker (Licence: PA SW130669) |
1041C0700X Social Worker, Clinical (Licence: PA CW018924) | |
Enumeration Date | 2014-02-28 |
Last Update Date | 2024-04-15 |