| NPI | 1811661333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180016139) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178013388) |
| Enumeration Date | 2021-08-07 |
| Last Update Date | 2024-06-12 |