| NPI | 1669702643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P1803032) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OK 4216) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2023-12-27 |