NPI | 1174968770 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 78453) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW62179) |
Enumeration Date | 2013-05-08 |
Last Update Date | 2021-04-03 |