NPI | 1518635473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 2862) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MS P-0533) |
Enumeration Date | 2021-09-03 |
Last Update Date | 2022-09-26 |