| NPI | 1851529937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149016089) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 15047) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2014-02-03 |