NPI | 1245565928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 29029) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2009-10-13 |
Last Update Date | 2022-02-11 |