NPI | 1528491834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ID LCSW-35672) |
Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW-33200) |
Enumeration Date | 2013-08-10 |
Last Update Date | 2023-06-12 |