NPI | 1942920277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 109714) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 109714) |
Enumeration Date | 2022-08-29 |
Last Update Date | 2023-06-27 |