NPI | 1063453496 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC000262) |
Additional Taxonomies | 101Y00000X Counselor (Licence: PA PC000262) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2010-07-12 |