NPI | 1891262572 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50082323) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904012829) |
Enumeration Date | 2018-10-31 |
Last Update Date | 2021-05-07 |