| NPI | 1669973541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.009050) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180009050) |
| 101YP2500X Counselor, Professional (Licence: 180.009050) | |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2021-01-20 |