NPI | 1679038251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180009038) |
Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180009038) |
Enumeration Date | 2019-02-07 |
Last Update Date | 2024-11-14 |