NPI | 1922409333 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C012638) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P010969) |
Enumeration Date | 2014-09-05 |
Last Update Date | 2022-03-31 |