| NPI | 1891039905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7136) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178005211) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2022-03-24 |