NPI | 1740517267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.014032) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149014032) |
Enumeration Date | 2009-11-04 |
Last Update Date | 2021-05-08 |