NPI | 1770274458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 119657) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 119657) |
Enumeration Date | 2023-05-15 |
Last Update Date | 2023-12-15 |