NPI | 1275778540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904006787) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC303339) |
1041C0700X Social Worker, Clinical (Licence: FL SW6341) | |
Enumeration Date | 2008-12-15 |
Last Update Date | 2008-12-15 |