| NPI | 1538488937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TN LPC0000002051) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-05-25 |