| NPI | 1689464034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19871) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 19871) |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |