NPI | 1649751447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180013584) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178014101) |
Enumeration Date | 2018-08-28 |
Last Update Date | 2022-09-28 |