NPI | 1952581183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 63900) |
Additional Taxonomies | 104100000X Social Worker |
1041C0700X Social Worker, Clinical (Licence: CA ASW 27563) | |
Enumeration Date | 2007-11-05 |
Last Update Date | 2022-10-05 |