NPI | 1730414053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: NC 717C23) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC 717C23) |
251S00000X (Licence: NC 717C23) | |
Enumeration Date | 2009-10-04 |
Last Update Date | 2024-01-18 |