| NPI | 1093708208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002212A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180005312) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-10-23 |