| NPI | 1801497839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV CP5754) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2025-05-15 |