NPI | 1144602541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801098023) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801098023) |
Enumeration Date | 2015-06-22 |
Last Update Date | 2018-12-12 |