NPI | 1114338811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AR P1704288) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AR A1404070) |
Enumeration Date | 2014-05-15 |
Last Update Date | 2018-08-06 |