| NPI | 1356350508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180001736) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-001736) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2025-08-26 |