| NPI | 1588477426 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.029689) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.112817) |
| Enumeration Date | 2025-01-27 |
| Last Update Date | 2025-10-21 |