| NPI | 1205408069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149020242) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34012044A) |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2025-11-24 |