NPI | 1861026544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM c-10953) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL FLSW16898) |
Enumeration Date | 2020-03-02 |
Last Update Date | 2024-12-19 |