NPI | 1720005440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34001917A) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149-001105) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2011-12-10 |