| NPI | 1013186618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 3454) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2016-12-23 |