NPI | 1871049445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 13556) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC NC003130) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2016-09-01 |