| NPI | 1184962375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 2518) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 2466) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2022-07-21 |