NPI | 1235368853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW00007448) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS 11329) |
Enumeration Date | 2009-07-02 |
Last Update Date | 2013-05-31 |