NPI | 1538705330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180.015783) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.014991) |
Enumeration Date | 2019-11-27 |
Last Update Date | 2024-07-26 |