| NPI | 1518245398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC3305) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ME CC3305) |
| 101YM0800X Counselor, Mental Health (Licence: ME CC3305) | |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2023-02-21 |