NPI | 1477079812 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 11316285-3501) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2017-08-17 |
Last Update Date | 2023-01-18 |