| NPI | 1184633349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NV 4910-C) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA LCS17609) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2010-06-11 |