| NPI | 1437895455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC014314) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA APC008297) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2024-01-24 |