| NPI | 1235757998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.025116) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LMSW-18402) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2023-02-07 |