NPI | 1003053786 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.013393) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2009-01-16 |
Last Update Date | 2018-07-09 |