| NPI | 1275333916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 13819) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 7995) |
| 372600000X Adult Companion | |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-31 |