NPI | 1376824649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60761384) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS28457) |
Enumeration Date | 2011-08-31 |
Last Update Date | 2019-03-26 |