| NPI | 1033803192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 87990) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: TX 1311834) |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |