NPI | 1487754263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM I-07022) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 989555) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2013-04-09 |