| NPI | 1841340197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 14207) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 32696) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |