NPI | 1679247605 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 127700) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 127700) |
Enumeration Date | 2021-08-03 |
Last Update Date | 2024-12-23 |