| NPI | 1841807823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME XL5331) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC7000) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2026-03-31 |