| NPI | 1790881969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW00008483) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 22292) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2008-01-25 |