| NPI | 1265295588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 88002185A) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: IN 88002185A) |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2025-08-01 |