NPI | 1538592191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 118856) |
Additional Taxonomies | 104100000X Social Worker (Licence: MA 218581) |
Enumeration Date | 2013-08-18 |
Last Update Date | 2024-11-22 |