NPI | 1245566983 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149014963) |
Additional Taxonomies | 104100000X Social Worker (Licence: LA 10790) |
104100000X Social Worker (Licence: IL 150012593) | |
Enumeration Date | 2009-10-31 |
Last Update Date | 2016-10-25 |