| NPI | 1134861503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 34009852A) |
| Additional Taxonomies | 104100000X Social Worker |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-08-18 |