| NPI | 1972299568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.029020) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 926645) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2025-03-24 |