NPI | 1225358229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4377) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 63169) |
Enumeration Date | 2010-06-02 |
Last Update Date | 2015-02-04 |