| NPI | 1710312269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180009697) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178009038) |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2020-10-06 |