NPI | 1619095163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC004833) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-03-26 |
Last Update Date | 2024-11-02 |