NPI | 1821221250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 82504) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NM M-08172) |
Enumeration Date | 2009-09-02 |
Last Update Date | 2018-05-22 |