NPI | 1316175201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: NC C007304) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC P005119) |
101Y00000X Counselor (Licence: NC 1529) | |
Enumeration Date | 2009-06-30 |
Last Update Date | 2012-03-12 |