NPI | 1386396091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 30198) |
Additional Taxonomies | 104100000X Social Worker (Licence: MN 30198) |
Enumeration Date | 2022-01-24 |
Last Update Date | 2023-08-15 |