NPI | 1083937536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0001056) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 077738-1) |
Enumeration Date | 2010-03-11 |
Last Update Date | 2011-04-25 |