| NPI | 1912878158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IL 150.117976) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL CADC-45140) |
| Enumeration Date | 2025-09-12 |
| Last Update Date | 2025-09-12 |