| NPI | 1568847028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39004076A) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401012887) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-10-18 |