NPI | 1356651186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P009057) |
Additional Taxonomies | 222Q00000X Developmental Therapist |
Enumeration Date | 2010-10-14 |
Last Update Date | 2014-10-31 |