| NPI | 1538559166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC6651) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.010560) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2019-09-16 |