| NPI | 1841797271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.021285) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 150.102995) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-10-13 |