| NPI | 1811900905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 1533) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TN LPC1533) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-10-14 |