| NPI | 1477337913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: ID LPC-9459) | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2024-08-08 |