| NPI | 1487911442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002629A) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2016-11-17 |