NPI | 1093178436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 75589) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 37336) |
Enumeration Date | 2016-04-02 |
Last Update Date | 2024-02-19 |