NPI | 1811026750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: IL 149000524) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149000524) |
Enumeration Date | 2007-03-05 |
Last Update Date | 2008-04-09 |