| NPI | 1225178049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 16299) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 16299) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-09-09 |