| NPI | 1306000203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH 7931) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH7931) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-07-26 |