| NPI | 1295283034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180012838) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178012334) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2020-03-23 |