NPI | 1215230818 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-007201) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149007201) |
Enumeration Date | 2010-12-21 |
Last Update Date | 2013-10-01 |