NPI | 1356514327 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 8525) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001531A) |
Enumeration Date | 2008-04-10 |
Last Update Date | 2011-10-10 |