NPI | 1386092237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 92984) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW70424) |
1041C0700X Social Worker, Clinical (Licence: IN 34009090A) | |
Enumeration Date | 2016-06-01 |
Last Update Date | 2023-11-01 |