NPI | 1477995249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW70491) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW09924003) |
Enumeration Date | 2013-07-22 |
Last Update Date | 2023-05-26 |