NPI | 1013118918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW4463) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 3403) |
Enumeration Date | 2007-05-29 |
Last Update Date | 2017-10-26 |