NPI | 1538884747 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C10195) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ID 8857) |
Enumeration Date | 2022-10-10 |
Last Update Date | 2025-07-15 |