| NPI | 1699701821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 2835) |
| 104100000X Social Worker (Licence: NM M-1108) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2010-01-13 |