| NPI | 1154709988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC 321) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH10287) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-13 |