NPI | 1487048070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 93830) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW65434) |
Enumeration Date | 2015-03-23 |
Last Update Date | 2020-01-24 |