| NPI | 1902395650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149.024518) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2022-06-03 |