| NPI | 1770089377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.024500) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-08-01 |