NPI | 1053423178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 514559) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TX LCSW514559) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2007-07-08 |