| NPI | 1528490893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AK 197557) |
| 101Y00000X Counselor (Licence: FL MH2484) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2025-03-28 |