| NPI | 1669998894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NH 6831) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2024-12-04 |