| NPI | 1467799908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 1467799908) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.015533) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2022-11-10 |