NPI | 1104855527 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AR 1680-C) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 004386) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2007-07-08 |