| NPI | 1558671982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 2255R0406X Specialist/Technologist, Rehabilitation, Blind |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2015-01-14 |