NPI | 1942331038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS 24473) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2007-03-08 |
Last Update Date | 2017-02-20 |