| NPI | 1669448502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39000021A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33000046A) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |