| NPI | 1033819008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD 13463) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YP2500X Counselor, Professional (Licence: MO 2024009461) | |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2026-04-17 |