| NPI | 1679318893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LGP12976) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC LGPC200001385) |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |