NPI | 1821597162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW19654) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 10282) |
Enumeration Date | 2018-02-01 |
Last Update Date | 2024-05-14 |