| NPI | 1144628785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 7325) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN LPC0000003227) |
| Enumeration Date | 2014-12-14 |
| Last Update Date | 2019-06-22 |