| NPI | 1962704825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 10407) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 79776) |
| 101YP2500X Counselor, Professional (Licence: FL MH19554) | |
| 101YP2500X Counselor, Professional (Licence: GA 012283) | |
| 101YP2500X Counselor, Professional (Licence: TN 2616) | |
| 101YP2500X Counselor, Professional (Licence: MA 7350) | |
| 101YP2500X Counselor, Professional (Licence: NY 011998) | |
| 101YP2500X Counselor, Professional (Licence: CT 6583) | |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2025-06-04 |