| NPI | 1831595164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180009448) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178009810) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2018-05-23 |