| NPI | 1083716997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39000886A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 35001289A) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2024-03-05 |