NPI | 1710918073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089-0001021) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2006-07-05 |
Last Update Date | 2022-06-06 |