NPI | 1972500916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 07035) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC300758) |
Enumeration Date | 2005-07-06 |
Last Update Date | 2007-07-08 |