| NPI | 1760684674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180004287) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 18004287) |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2025-07-03 |