NPI | 1386734341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 88898) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 15195) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2024-03-18 |