| NPI | 1407274046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE PC-0000370) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DE PC-0000370) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-03-07 |