| NPI | 1538410857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TN 2911) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN 2911) |
| 102L00000X Psychoanalyst (Licence: TN 2911) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2013-09-06 |