NPI | 1023185402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 004400) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 045523-1) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2007-07-08 |