| NPI | 1669036489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IL 149.024629) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.10375) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2025-11-17 |