NPI | 1801577721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 23-QMHP-R-2184) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR 23-QMHP-R-2184) |
Enumeration Date | 2023-07-25 |
Last Update Date | 2023-10-17 |