| NPI | 1427116060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 394) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NE 878) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |