| NPI | 1720553936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.020409) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1041C0700X Social Worker, Clinical (Licence: IL 149020409) | |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2018-10-04 |