NPI | 1588971907 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2006037997) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2010-09-07 |
Last Update Date | 2016-08-10 |