NPI | 1386925287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 88092) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW35465) |
104100000X Social Worker (Licence: CA 35465) | |
Enumeration Date | 2011-09-06 |
Last Update Date | 2021-11-30 |