NPI | 1306478094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC LGPC00664) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP10135) |
Enumeration Date | 2020-02-10 |
Last Update Date | 2020-07-22 |