NPI | 1679997134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005582) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS18569) |
Enumeration Date | 2014-02-04 |
Last Update Date | 2016-12-21 |