| NPI | 1386902930 |
|---|---|
| Other Name | MIKE LAG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI 4152) |
| Additional Taxonomies | 104100000X Social Worker (Licence: HI 1678) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2018-12-29 |