| NPI | 1134729981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39000022A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000900A) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |