| NPI | 1447625777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CTB-2023-0171) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM CTB-2023-0171) |
| 101Y00000X Counselor | |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2025-03-05 |