NPI | 1598463028 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 101657) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 101657) |
Enumeration Date | 2023-02-23 |
Last Update Date | 2024-06-24 |