| NPI | 1831847409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 3098) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: KS 03098) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-03-14 |