NPI | 1760843486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C012646) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 088671) |
Enumeration Date | 2016-03-08 |
Last Update Date | 2024-04-17 |