| NPI | 1548410194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TN 1752) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P0803032) |
| 101YP2500X Counselor, Professional (Licence: TN LPC0000001752) | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2025-02-10 |