NPI | 1952165052 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 120703) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 120703) |
Enumeration Date | 2024-02-08 |
Last Update Date | 2024-04-17 |