NPI | 1558729590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW006477) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NJ 44sc05669600) |
Enumeration Date | 2016-02-05 |
Last Update Date | 2020-01-06 |