NPI | 1811445067 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 69011) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
101YP2500X Counselor, Professional (Licence: CA 69011) | |
Enumeration Date | 2016-09-16 |
Last Update Date | 2017-01-25 |