NPI | 1245667880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 77008) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 36466) |
Enumeration Date | 2013-09-27 |
Last Update Date | 2018-12-31 |