| NPI | 1942886049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.110071) |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2024-03-13 |