| NPI | 1467551036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149012841) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150010660) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-02-07 |