| NPI | 1265904858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149018551) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.018551) |
| 1041C0700X Social Worker, Clinical (Licence: 149018551) | |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2023-05-02 |