| NPI | 1437166162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM 0183) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: NM 224-044) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |