NPI | 1629017868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 82079) |
Additional Taxonomies | 104100000X Social Worker (Licence: OH I0009706) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2022-06-30 |