| NPI | 1538333471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1075) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1861) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2023-11-28 |