NPI | 1053442335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW70058) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 34699) |
1041C0700X Social Worker, Clinical (Licence: CA 70058) | |
171M00000X Case Manager/Care Coordinator (Licence: CA 70058) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2022-02-22 |