| NPI | 1922268093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK 556) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AK PCOP556) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2020-07-01 |