| NPI | 1932320942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 19851) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional (Licence: TX 19851) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2025-06-26 |