| NPI | 1124041199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149011481) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 149011481) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-07-08 |