NPI | 1053628610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MA 875586) |
Enumeration Date | 2010-09-02 |
Last Update Date | 2010-09-02 |