| NPI | 1730898370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149025686) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 104100000X Social Worker | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2023-06-19 |