| NPI | 1861809956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180010058) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178008735) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2017-04-28 |