NPI | 1649380502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM I2267) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 05339) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-07-08 |