| NPI | 1346720711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178012374) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 5373) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2023-04-11 |