NPI | 1629863923 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 12724) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OK 12724) |
Enumeration Date | 2025-04-09 |
Last Update Date | 2025-04-24 |