| NPI | 1740246057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 5954) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2002012996) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-07-28 |