NPI | 1104846310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 1878) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 1878B) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2008-06-10 |