| NPI | 1285139998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 4607) |
| Additional Taxonomies | 101Y00000X Counselor |
| 174400000X Specialist | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-05-07 |