NPI | 1467962555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW95780) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 78309) |
104100000X Social Worker (Licence: CA LCSW95780) | |
Enumeration Date | 2017-10-03 |
Last Update Date | 2023-07-11 |