| NPI | 1356525240 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002874A) | 
| Additional Taxonomies | 104100000X Social Worker | 
| Enumeration Date | 2007-12-27 | 
| Last Update Date | 2020-11-30 |