NPI | 1841614161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 61553) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 201794) |
Enumeration Date | 2014-02-06 |
Last Update Date | 2022-06-27 |