NPI | 1518224419 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: TX 107495) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802085802) |
Enumeration Date | 2012-04-16 |
Last Update Date | 2023-03-21 |