| NPI | 1568277283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.021397) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 8331727) |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-03-10 |