NPI | 1114939576 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 2244) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS 0226) |
Enumeration Date | 2006-08-13 |
Last Update Date | 2007-07-08 |