NPI | 1104178649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180015933) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178006138) |
Enumeration Date | 2012-10-08 |
Last Update Date | 2024-10-09 |