| NPI | 1134516966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6803084151) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 68030884151) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |