NPI | 1598818072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000326) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 10735) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2007-07-08 |