| NPI | 1437471299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P8611021) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2021010667) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2024-10-09 |