NPI | 1871642058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW75376) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA ASW 29730) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2023-04-26 |