NPI | 1821431362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA 020704 LW00007092) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: WA 4014655) |
Enumeration Date | 2013-04-15 |
Last Update Date | 2013-04-15 |