NPI | 1043739949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.019739) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2017-09-12 |
Last Update Date | 2022-07-21 |