| NPI | 1467270322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180.017313) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178016675) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-07-28 |