| NPI | 1780211052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.022123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L6973) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149022123) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2021-12-30 |