| NPI | 1184851370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: FL 744979) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 43095) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |