NPI | 1518683671 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0014241) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0014241) |
Enumeration Date | 2022-10-19 |
Last Update Date | 2023-05-23 |