NPI | 1407137466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW74251) |
Additional Taxonomies | 104100000X Social Worker |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2011-09-06 |
Last Update Date | 2022-11-30 |