| NPI | 1043533045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C014359) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.013557) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2024-04-09 |