NPI | 1104001726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401012429) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6803085803) |
Enumeration Date | 2008-01-02 |
Last Update Date | 2020-07-07 |