| NPI | 1891380945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 4604) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180016598) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2026-08-31 |