NPI | 1134194467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801034036) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 05842) |
1041C0700X Social Worker, Clinical (Licence: MI 6801034036) | |
Enumeration Date | 2006-02-21 |
Last Update Date | 2013-09-20 |