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 |