| NPI | 1548491301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149007865) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC302726) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2010-08-25 |