NPI | 1902821549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8819) |
Additional Taxonomies | 101Y00000X Counselor (Licence: SC 4707) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2022-11-28 |