| NPI | 1144438201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 11096) |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL SW 11096) |
| 104100000X Social Worker (Licence: MI 6801062493) | |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801062493) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-01-31 |