| NPI | 1295070803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA APC003284) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: GA APC003284) | |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2012-12-07 |