| NPI | 1316491848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IN 39003187A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701006491) |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2020-11-28 |