| NPI | 1831641000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.018913) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: IL 1001163) |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |