| NPI | 1225722846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 178021059) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IN 88001980A) |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2025-01-17 |