| NPI | 1861563181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 87001528A) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2019-06-19 |