| NPI | 1144457052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TN 2471) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TN LPC 2471) |
| 101YP2500X Counselor Professional (Licence: GA 6453) | |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2019-11-15 |