NPI | 1821477142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0017413) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CO 0017413) |
Enumeration Date | 2015-05-19 |
Last Update Date | 2024-02-13 |