NPI | 1609991231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CP00006170) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA RC00044915) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2023-09-07 |