NPI | 1225192461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34001364A) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I0004769) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2013-08-28 |