| NPI | 1437669272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 4614) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 180010948) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2018-01-18 |