| NPI | 1487540191 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010116) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-07-08 |