NPI | 1194264549 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 347C00000X Private Vehicle (Licence: MN 902963300022) |
Enumeration Date | 2017-02-17 |
Last Update Date | 2021-10-25 |