NPI | 1265663884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NM I-07430) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NM M 06813) |
Enumeration Date | 2009-07-30 |
Last Update Date | 2012-12-13 |