NPI | 1770108433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 108203) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW16306) |
Enumeration Date | 2020-06-09 |
Last Update Date | 2024-07-23 |