| NPI | 1245423896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-011792) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149011792) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2014-09-03 |