| NPI | 1952094880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180018722) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178019110) |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2026-09-02 |