NPI | 1033286414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MN 12688) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MN 300215) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2009-08-12 |