NPI | 1588057558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW112669) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2015-03-13 |
Last Update Date | 2023-01-13 |