NPI | 1235372095 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 112845) |
Additional Taxonomies | 104100000X Social Worker (Licence: KY 5519) |
Enumeration Date | 2009-04-09 |
Last Update Date | 2023-01-20 |