NPI | 1689244113 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C015963) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 30566) |
Enumeration Date | 2021-06-28 |
Last Update Date | 2024-07-13 |