NPI | 1922581859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 06152) |
Additional Taxonomies | 172V00000X Community Health Worker |
Enumeration Date | 2018-09-06 |
Last Update Date | 2024-07-22 |