NPI | 1811285935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW35354) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2011-07-11 |
Last Update Date | 2016-04-11 |