NPI | 1144670571 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 25703) |
Additional Taxonomies | 104100000X Social Worker (Licence: MN AP16-1031) |
Enumeration Date | 2016-06-16 |
Last Update Date | 2021-04-29 |