NPI | 1366060469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 10053-123) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 131888-121) |
Enumeration Date | 2020-07-06 |
Last Update Date | 2022-12-12 |