| NPI | 1386799468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE PC-0000778) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: DE PC-0000778) |
| 101YP2500X Counselor, Professional (Licence: DE PC-0000778) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-12-01 |