NPI | 1336517721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C3873) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 1452) |
Enumeration Date | 2015-09-02 |
Last Update Date | 2024-06-25 |