NPI | 1437621620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 680184479) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 680184479) |
Enumeration Date | 2018-12-28 |
Last Update Date | 2018-12-31 |