| NPI | 1629673314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180015275) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178016413) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2023-05-23 |