NPI | 1588029177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC14712) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A1512162) |
Enumeration Date | 2015-12-23 |
Last Update Date | 2025-06-02 |