NPI | 1831240837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW 0611) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LISAC 1029) |
Enumeration Date | 2007-01-16 |
Last Update Date | 2010-04-05 |