| NPI | 1336700236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39004109A) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IN 87001667A) |
| 101YM0800X Counselor Mental Health (Licence: IN 88000903A) | |
| Enumeration Date | 2019-06-22 |
| Last Update Date | 2021-11-17 |