NPI | 1346092111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801109717) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801109717) |
Enumeration Date | 2024-04-03 |
Last Update Date | 2024-10-16 |