NPI | 1689862088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 22640) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 22640) |
Enumeration Date | 2007-10-10 |
Last Update Date | 2023-04-13 |