| NPI | 1174899769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IN LCDCII.121041) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN CII-1337) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2022-12-28 |