NPI | 1528736535 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MA 226344) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 226344) |
Enumeration Date | 2021-09-03 |
Last Update Date | 2023-05-02 |