NPI | 1326795055 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09930298) |
Additional Taxonomies | 104100000X Social Worker (Licence: CO LSW.0009922925) |
Enumeration Date | 2022-03-02 |
Last Update Date | 2024-04-02 |