| NPI | 1720312283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 3491-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 29549) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2014-12-02 |