NPI | 1548396146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 26170 CSW) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW15170) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2016-02-25 |