NPI | 1730415498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 09005) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078009) |
Enumeration Date | 2009-10-29 |
Last Update Date | 2023-03-23 |