NPI | 1497378616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2103771) |
101Y00000X Counselor (Licence: OR C7584) | |
Enumeration Date | 2020-05-21 |
Last Update Date | 2025-08-18 |