| NPI | 1215390265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 12387) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2025-01-22 |