NPI | 1225309032 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 119082) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2012-01-25 |
Last Update Date | 2015-09-28 |