| NPI | 1609905587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 2465) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2010-10-04 |