NPI | 1679058127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 27646) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2018-10-01 |
Last Update Date | 2021-04-23 |