NPI | 1659462802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 24523) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 005136) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2009-12-31 |