NPI | 1285484139 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 88131) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 88131) |
Enumeration Date | 2024-03-25 |
Last Update Date | 2024-08-29 |