| NPI | 1003066234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39002199A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2020-07-17 |