| NPI | 1184441578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1381-26202844) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 101ym0800) |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-09-25 |