NPI | 1790860039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW62712) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 114722) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2014-08-20 |