| NPI | 1881004752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180013858) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180013858) |
| 101Y00000X Counselor | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2024-11-06 |