| NPI | 1437599743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P1807097) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: A1607088) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2021-03-12 |