| NPI | 1457915365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NV CP1284R) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178010953) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2025-01-22 |