| NPI | 1568781177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149.014062) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 2022014357) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2024-11-05 |