NPI | 1477695120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA ASW76352) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2007-02-12 |
Last Update Date | 2020-01-06 |