| NPI | 1871884536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 5086) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2021-07-19 |