NPI | 1851364244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701003278) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701003278) |
Enumeration Date | 2006-02-08 |
Last Update Date | 2020-04-14 |