NPI | 1700352036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801103491) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801103491) |
Enumeration Date | 2018-10-14 |
Last Update Date | 2018-10-14 |