| NPI | 1588701817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK LPC2540) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 2540) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2009-12-07 |