NPI | 1285858746 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW002905) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW6102) |
Enumeration Date | 2007-04-13 |
Last Update Date | 2007-07-08 |