NPI | 1801117882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-11749) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 082916-01) |
1041C0700X Social Worker, Clinical (Licence: OR L7021) | |
Enumeration Date | 2010-06-14 |
Last Update Date | 2023-09-08 |