| NPI | 1376186650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 178015317) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 270000217) |
| Enumeration Date | 2019-10-19 |
| Last Update Date | 2019-10-19 |