NPI | 1659744985 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 119260) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149016039) |
Enumeration Date | 2015-11-09 |
Last Update Date | 2015-11-09 |