| NPI | 1104253319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180010635) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2020-07-17 |