NPI | 1447765110 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: TX 64163) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 64163) |
Enumeration Date | 2017-12-04 |
Last Update Date | 2024-07-29 |