NPI | 1417352329 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010562) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P009153) |
Enumeration Date | 2014-11-04 |
Last Update Date | 2020-07-08 |