NPI | 1346510351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 005091) |
Additional Taxonomies | 104100000X Social Worker (Licence: CT 005091) |
Enumeration Date | 2012-01-06 |
Last Update Date | 2012-02-16 |