NPI | 1831529395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 11260) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC007538) |
Enumeration Date | 2013-11-20 |
Last Update Date | 2025-08-03 |