| NPI | 1124480595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 18012203) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178011862) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2022-08-05 |