| NPI | 1912035049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.006127) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 2033) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2014-05-27 |