| NPI | 1841426814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 3734) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 3840) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2017-01-24 |