NPI | 1710072178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 2740) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MS C8179) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2014-12-02 |