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 |