NPI | 1336220151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW24238) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-10-18 |
Last Update Date | 2009-05-08 |