| NPI | 1295096220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 5685) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 003343) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-07-27 |