| NPI | 1235685983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180012749) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL TPMC2322) |
| 101YP2500X Counselor, Professional (Licence: IN 39003854A) | |
| 101YP2500X Counselor, Professional (Licence: IL 180012749) | |
| 101YP2500X Counselor, Professional (Licence: WI 6852-25) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2026-04-15 |