NPI | 1538202635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 49290) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2011-05-05 |