NPI | 1881004620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401223142) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401223142) |
Enumeration Date | 2014-05-01 |
Last Update Date | 2025-06-12 |