NPI | 1629152376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS24329) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 12370) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2021-12-02 |