NPI | 1821189523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 22095) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS22095) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2022-04-27 |