| NPI | 1659076073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.017880) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |