| NPI | 1447065198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MP 0011) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178021273) |
| 101YS0200X Counselor, School (Licence: WI 3001026598) | |
| 101YS0200X Counselor, School (Licence: AK 4127755) | |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-04-29 |