NPI | 1003133810 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 28548) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM I-07166) |
Enumeration Date | 2010-05-03 |
Last Update Date | 2023-08-25 |