| NPI | 1699954883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IN 39005548A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.008755) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2026-05-05 |