NPI | 1801347232 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 9854) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 9845) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2023-09-19 |