NPI | 1245299601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801070289) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2006-03-22 |
Last Update Date | 2007-07-08 |