| NPI | 1497590277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: TN 000748846) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-06-25 |