| NPI | 1275783268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW79005) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078569) |
| 1041C0700X Social Worker, Clinical (Licence: MD 14462) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2020-04-17 |