| NPI | 1386881043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39000547A) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 261338) |
| 101YP2500X Counselor, Professional (Licence: TN LPC0000002204) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2025-09-11 |