NPI | 1629358437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 37215) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2011-08-24 |
Last Update Date | 2013-10-10 |