NPI | 1699361659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 082592) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW018008) |
Enumeration Date | 2020-12-14 |
Last Update Date | 2020-12-14 |