| NPI | 1851345276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE PC-00001) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC-0209) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2009-05-19 |