NPI | 1780118729 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 74509) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 74509) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2024-02-07 |