| NPI | 1255710950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IL 150013100) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW17734) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2024-07-03 |