| NPI | 1083944656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I. 1101243) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149016358) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2020-07-27 |