NPI | 1225330350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801108325) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 93749) |
Enumeration Date | 2010-11-22 |
Last Update Date | 2021-08-31 |