| NPI | 1447398052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010265) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180002419) |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2007-07-08 |