NPI | 1710203278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 17643) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 61201) |
Enumeration Date | 2010-04-08 |
Last Update Date | 2015-02-26 |