NPI | 1942642590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW81067) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2013-07-24 |
Last Update Date | 2020-07-09 |