| NPI | 1538210232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 218) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 469) |
| 101YM0800X Counselor, Mental Health (Licence: NE 726) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2024-05-11 |