NPI | 1801092762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401012311) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802073208) |
Enumeration Date | 2007-06-26 |
Last Update Date | 2016-11-17 |