NPI | 1508096033 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C006770) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW016573) |
Enumeration Date | 2009-07-17 |
Last Update Date | 2022-02-09 |