NPI | 1386833861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-02592) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 002143) |
Enumeration Date | 2007-10-19 |
Last Update Date | 2007-10-19 |