| NPI | 1720649387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3601) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL 16295) |
| 101YP2500X Counselor, Professional (Licence: TN 2896) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |