NPI | 1477070274 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801114544) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801098379) |
Enumeration Date | 2017-08-23 |
Last Update Date | 2023-06-20 |