| NPI | 1477101830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: E.2404113) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.2404113) |
| 101Y00000X Counselor | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2025-08-19 |