| NPI | 1881925485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002113A) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2020-12-22 |