| NPI | 1053649301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-005085) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IN 180.005086) |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2023-11-22 |