NPI | 1740319318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801086119) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801086119) |
Enumeration Date | 2007-03-02 |
Last Update Date | 2012-09-28 |