| NPI | 1770397119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178.021349) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.017627) |
| Enumeration Date | 2025-02-05 |
| Last Update Date | 2025-11-13 |