| NPI | 1568710325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IL 150013790) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S1601171) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2022-07-21 |