| NPI | 1649448895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL MH19106) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC009958) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2024-07-03 |