NPI | 1699221440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71886) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 35680) |
Enumeration Date | 2016-08-31 |
Last Update Date | 2017-04-18 |