NPI | 1609975671 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801018152) |
Additional Taxonomies | 1041C0700X Social Worker Clinical |
Enumeration Date | 2006-09-22 |
Last Update Date | 2024-01-30 |