NPI | 1295109791 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 15421) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 15421) |
Enumeration Date | 2015-11-20 |
Last Update Date | 2025-09-10 |