| NPI | 1699985887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NV 01709-C) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-12-05 |