NPI | 1023563988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801067489) |
Additional Taxonomies | 1041S0200X Social Worker, School |
Enumeration Date | 2016-08-22 |
Last Update Date | 2016-08-22 |