NPI | 1851799985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8686227-3501) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 8686227-3502) |
Enumeration Date | 2014-12-05 |
Last Update Date | 2016-06-20 |