| NPI | 1659795078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007647) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN LPC0000002186) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-05 |