NPI | 1356681944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 101383) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 71826) |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2013-02-19 |
Last Update Date | 2021-06-16 |