NPI | 1033245857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 25999) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2007-02-26 |
Last Update Date | 2021-12-20 |