NPI | 1487830170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 079921) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 75294) |
Enumeration Date | 2008-01-14 |
Last Update Date | 2017-04-11 |