NPI | 1538116140 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA 020704) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR 350985) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2007-07-08 |