| NPI | 1952128928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IL 150114317) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 150114317) |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2026-04-16 |