NPI | 1700946027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801089549) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS22956) |
Enumeration Date | 2006-12-08 |
Last Update Date | 2008-11-07 |