NPI | 1467945493 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 112411) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 91386) |
Enumeration Date | 2018-06-13 |
Last Update Date | 2023-09-26 |