NPI | 1134340672 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000970) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 11349) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2009-08-04 |