| NPI | 1447461710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL PMH 909) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39001268A) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2009-02-18 |