NPI | 1861196370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 93585) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 56818) |
Enumeration Date | 2023-03-28 |
Last Update Date | 2023-03-30 |