| NPI | 1093993826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801067655) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2017-05-22 |