| NPI | 1518524396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 4429) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ C3153A) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2024-06-03 |