NPI | 1306054986 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 3808) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 4882) |
Enumeration Date | 2007-05-18 |
Last Update Date | 2021-03-11 |