| NPI | 1598994899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 5094) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5094) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2024-08-09 |