NPI | 1629131388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: CT 000631) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 000631) |
Enumeration Date | 2006-12-17 |
Last Update Date | 2018-05-01 |