| NPI | 1841678976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK 173365) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00568100) |
| 101YP2500X Counselor, Professional | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2022-11-29 |