NPI | 1689176018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 23190) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50080437) |
Enumeration Date | 2018-03-01 |
Last Update Date | 2024-06-10 |