NPI | 1023346012 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc00629) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4851-125) |
Enumeration Date | 2009-12-02 |
Last Update Date | 2013-10-03 |