| NPI | 1811237340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK 097178) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: OK 097178) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-02-20 |