| NPI | 1447749940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.022811) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2020-12-18 |