NPI | 1730423393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.009981) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.008592) |
Enumeration Date | 2012-11-20 |
Last Update Date | 2016-03-07 |