NPI | 1811343866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: MN 22769) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: MN 476865) |
Enumeration Date | 2016-05-09 |
Last Update Date | 2018-05-01 |