NPI | 1508028507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW70065) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2008-06-30 |
Last Update Date | 2016-03-04 |