NPI | 1699226084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 77903) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2022-07-21 |