NPI | 1831336056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 16517) |
Additional Taxonomies | 104100000X Social Worker (Licence: MD G12869) |
Enumeration Date | 2009-01-09 |
Last Update Date | 2010-11-18 |