| NPI | 1619127842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE PC-0000449) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC008423) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2024-03-05 |