NPI | 1316445422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801114537) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2018-01-24 |
Last Update Date | 2023-10-27 |