| NPI | 1801276506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005196) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149014881) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |