| NPI | 1427297787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 26662) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2022-12-01 |