| NPI | 1861749400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.028980) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2025-03-17 |