NPI | 1427483205 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 80508) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 80508) |
Enumeration Date | 2013-09-11 |
Last Update Date | 2018-07-30 |