NPI | 1093877409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR LCSW#3328) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCSW#7966) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2016-03-14 |