| NPI | 1518431683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.024612) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2023-06-17 |