NPI | 1720676893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 99754) |
Additional Taxonomies | 104100000X Social Worker |
1041C0700X Social Worker, Clinical (Licence: CA 99754) | |
Enumeration Date | 2021-01-05 |
Last Update Date | 2022-11-21 |