NPI | 1760112999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 150.106068) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: IL 150.106068) |
Enumeration Date | 2022-06-11 |
Last Update Date | 2022-06-11 |