| NPI | 1821622267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA 013730) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2025-08-22 |