NPI | 1588984637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 812) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY 414) |
Enumeration Date | 2010-06-10 |
Last Update Date | 2020-09-08 |