NPI | 1780177998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.022259) |
Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.103114) |
Enumeration Date | 2018-06-12 |
Last Update Date | 2023-03-16 |