| NPI | 1558817619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39003406A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 39003406A) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2024-05-14 |