| NPI | 1710406558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180012662) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-08-22 |