NPI | 1811286131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-34084) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1041C0700X Social Worker, Clinical (Licence: WY PCSW-512) | |
1041C0700X Social Worker, Clinical (Licence: ID LMSW-33546) | |
Enumeration Date | 2011-04-07 |
Last Update Date | 2015-08-19 |