| NPI | 1033626601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39004284A) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2022-10-25 |