NPI | 1770781825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 5953) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 3032) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2017-01-18 |