| NPI | 1154189249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 178019969) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 88000393A) |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2024-03-26 |