NPI | 1134340979 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 4210) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L2833) |
1041C0700X Social Worker, Clinical (Licence: WA LW00007242) | |
Enumeration Date | 2007-05-01 |
Last Update Date | 2007-07-08 |