| 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 |