NPI | 1669710042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW94690) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW35792) |
104100000X Social Worker | |
171M00000X Case Manager/Care Coordinator (Licence: CA ASW35792) | |
Enumeration Date | 2013-01-20 |
Last Update Date | 2020-05-14 |