| NPI | 1396225504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 2608) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR A1708258) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2024-04-03 |