NPI | 1942431176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 15294) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078802) |
251S00000X (Licence: DC LC50078802) | |
Enumeration Date | 2009-08-05 |
Last Update Date | 2010-04-19 |