| NPI | 1861270985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 9356) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 6625) |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2024-03-27 |