NPI | 1215017009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 19143) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV 5980-C) |
1041C0700X Social Worker, Clinical (Licence: MD 26960) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2024-10-09 |