| NPI | 1528265576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 7187) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MN 166404) |
| 1041C0700X Social Worker, Clinical (Licence: MN 07187) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-07-29 |