NPI | 1942459995 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 103853) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW25968) |
Enumeration Date | 2008-09-15 |
Last Update Date | 2024-08-19 |