| NPI | 1891157913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 29318) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.015451) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2024-03-13 |