NPI | 1356445951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX S14147) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX S14147) |
Enumeration Date | 2006-09-12 |
Last Update Date | 2007-12-12 |