| NPI | 1942974381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 6546) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL LPC05713) |
| Enumeration Date | 2021-08-08 |
| Last Update Date | 2026-03-17 |