| NPI | 1396022075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013970) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO NLC 0104553) |
| 101Y00000X Counselor (Licence: AR A1101005) | |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2023-08-16 |