| NPI | 1588023857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006537) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC PRC14581) |
| 101YP2500X Counselor, Professional (Licence: PA PC007917) | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2016-11-02 |