| NPI | 1841659448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801115569) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801098905) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2022-12-21 |