NPI | 1821762220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MD 07251) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD A0611) |
Enumeration Date | 2021-08-09 |
Last Update Date | 2025-03-07 |