NPI | 1801802822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801002634) |
Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: MI 6801002634) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2008-05-19 |