| NPI | 1417772708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: CO 24407356) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPCC.0021454) |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |