| NPI | 1538550819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.023744) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM C-10005) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2023-11-15 |