| NPI | 1538117296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC0443) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LCM091) |
| 101YP2500X Counselor, Professional (Licence: VA 0717000761) | |
| 101YP2500X Counselor, Professional (Licence: VA 0701000470) | |
| 101YP2500X Counselor, Professional (Licence: DC PRC111) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-07-08 |