NPI | 1982720074 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS26218) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW18242) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2012-10-30 |