| NPI | 1942638010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL LH11305) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL LH11905) |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2023-07-27 |