NPI | 1376726018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: DE Q1-0001531) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: PA SW125896) |
Enumeration Date | 2007-12-17 |
Last Update Date | 2020-09-29 |