NPI | 1346386034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC302230) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 07612) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2007-07-08 |