NPI | 1285402529 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149027547) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 150106629) |
Enumeration Date | 2023-12-15 |
Last Update Date | 2024-08-06 |