| NPI | 1962883496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: NY 934925151) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: 936088151) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2015-06-10 |