NPI | 1871904003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO CSW.09924410) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO LSW.0009920312) |
Enumeration Date | 2014-05-09 |
Last Update Date | 2018-03-17 |