| NPI | 1780628958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 35000303A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39000268A) |
| 101YM0800X Counselor, Mental Health (Licence: IN 34002306A) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2016-08-31 |