| NPI | 1134907298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.026805) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34010635A) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2025-11-07 |