NPI | 1740307289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000934) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078329) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2014-09-27 |