| NPI | 1285402529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149027547) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 150106629) |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2026-05-22 |