| NPI | 1942407010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA FC00000109) |
| Additional Taxonomies | 171W00000X Contractor (Licence: OR POLYG EXAMINER - 173) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |