| NPI | 1780141432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DE PC-0011441) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC009974) |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2025-07-24 |