NPI | 1720565054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 86377) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 86377) |
Enumeration Date | 2018-07-19 |
Last Update Date | 2023-06-29 |