| NPI | 1922146950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-13780) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS 25641) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2013-02-15 |