NPI | 1073749982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 7410) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 05301) |
Enumeration Date | 2009-06-05 |
Last Update Date | 2021-06-09 |