| NPI | 1205059532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180005526) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-005526) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2025-04-23 |