| NPI | 1437041282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: OR 529471) |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-07-16 |