NPI | 1053626481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C8622) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NV CP1056) |
Enumeration Date | 2010-08-10 |
Last Update Date | 2025-04-17 |