NPI | 1831216795 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NM 0152331) |
Enumeration Date | 2007-03-24 |
Last Update Date | 2022-07-20 |