| NPI | 1881371268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149025227) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000008629) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-06-28 |