NPI | 1023464948 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4910) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2019002608) |
Enumeration Date | 2016-05-10 |
Last Update Date | 2025-03-18 |