NPI | 1023116324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401012192) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802076772) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2015-04-18 |