| NPI | 1831984186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX LPC.101075) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO PC.0022108) |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2026-07-13 |