| NPI | 1922215441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 471) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 388) |
| 101YM0800X Counselor, Mental Health (Licence: NE 737) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2016-08-22 |