NPI | 1063824241 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0006277) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 6277) |
Enumeration Date | 2014-05-22 |
Last Update Date | 2019-08-08 |