NPI | 1538575972 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 15700) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5695) |
Enumeration Date | 2014-07-07 |
Last Update Date | 2020-04-20 |