| NPI | 1871040725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: DC PRC14848) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: DC PRC14848) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2021-09-01 |