NPI | 1144396870 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS23039) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA LCS23039) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2013-12-12 |