| NPI | 1518536994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC7554) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME XL6291) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2024-08-08 |