| NPI | 1306885363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13381) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: FL AS2778) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-02-25 |