| NPI | 1336807478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL MH25060) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 19382) |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2026-01-08 |