NPI | 1568821973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI 3920) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW61618529) |
Enumeration Date | 2016-02-12 |
Last Update Date | 2025-05-19 |