NPI | 1285935916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50080049) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW017945) |
Enumeration Date | 2010-11-11 |
Last Update Date | 2014-12-30 |