| NPI | 1295204402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YS0200X Counselor, School (Licence: GA 059332319) | |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |