NPI | 1447980461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0021954) |
Additional Taxonomies | 101Y00000X Counselor |
101Y00000X Counselor (Licence: CO LPCC.0020347) | |
Enumeration Date | 2022-06-13 |
Last Update Date | 2025-03-21 |