NPI | 1861084188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA 101505) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 83812) |
Enumeration Date | 2021-02-08 |
Last Update Date | 2023-05-08 |