| NPI | 1134559222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.011306) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 4229) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2022-12-21 |