| NPI | 1891937736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149007999) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000005682) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2018-06-04 |