| NPI | 1508983396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 613) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN 613) |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2017-10-23 |