NPI | 1174121495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178016192) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.016192) |
Enumeration Date | 2020-10-09 |
Last Update Date | 2023-12-27 |