NPI | 1952410847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801086739) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: 6801086739) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2020-06-26 |