| NPI | 1659334407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: PR 15414) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2011-02-10 |