NPI | 1316310253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P2107012) |
Additional Taxonomies | 103T00000X Psychologist (Licence: AR 202389EX) |
Enumeration Date | 2015-10-31 |
Last Update Date | 2025-10-03 |