| NPI | 1821143512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE LIMHP 1050) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1876) |
| 101YM0800X Counselor, Mental Health (Licence: NE 3534) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2021-01-26 |