| NPI | 1891883732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701004624) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0718000125) |
| 101YP2500X Counselor, Professional (Licence: DC PRC1341) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-10-26 |