NPI | 1962939629 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 7999048-3501) |
Enumeration Date | 2017-05-12 |
Last Update Date | 2022-06-28 |