| NPI | 1184471476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2024029172) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-08-23 |