| NPI | 1780348987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC LGPC00918) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-10-25 |