| NPI | 1528288891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149004943) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149004943 LCSW) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2023-02-16 |