| NPI | 1437605458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71701) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2024-07-29 |