| NPI | 1447550405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 64708) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |