| NPI | 1346564226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180011685) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178006190) |
| Enumeration Date | 2010-03-20 |
| Last Update Date | 2018-08-21 |