NPI | 1376090480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C012229) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P010853) |
Enumeration Date | 2016-09-07 |
Last Update Date | 2022-11-10 |