NPI | 1033524236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 104746) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY KY - 0223) |
Enumeration Date | 2014-06-25 |
Last Update Date | 2016-06-06 |