| NPI | 1740667385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178010039) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2023-12-07 |