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 |