| NPI | 1427495001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149029789) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW 13222) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2025-09-30 |