NPI | 1891984571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000004802) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
1041C0700X Social Worker, Clinical (Licence: MS C10431) | |
Enumeration Date | 2007-10-18 |
Last Update Date | 2023-12-05 |