NPI | 1881006161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0001465) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA SW131956) |
Enumeration Date | 2014-05-21 |
Last Update Date | 2022-07-21 |