| NPI | 1457676223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64024) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: TX Grades EC-12) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-06-11 |