| NPI | 1447063631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.031096) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33012367A) |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2026-02-04 |