NPI | 1568530327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 34752) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 071689) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2025-06-18 |